tbuckley/cabot-search huggingface dataset:
POS1592-HPR UTILISING THE PERSPECTIVES OF PATIENTS WITH FIBROMYALGIA ON PHYSICAL ACTIVITY PROMOTION: A QUALITATIVE STUDY
Authors: N. Sermenli Aydin, F. Saritas, E. Tonga
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Physical activity (PA) promotion remains a significant clinical challenge in patients with fibromyalgia (FM) despite its evidenced beneficial impact on health outcomes [1]. Integrating behavior change theory into PA interventions ensures efficient interventions through the understanding of PA behaviors [2]. <h3>Objectives</h3> The aim of this study was to determine the behaviours, needs and beliefs of patients with FM regarding PA interventions with the use of Social Cognitive Theory (SCT) constructs. <h3>Methods</h3> A Qualitative study was designed using semi-structured interviews according to 5 SCT constructs (ie, Behavioral Capability, Outcome Expectations, Self-efficacy, Self-regulation, Social Support). Female patients with FM, aged between 18-65 years (n=10) were interviewed for 30-60 minutes. Data were audio recorded, transcribed verbatim and analyzed using the content analysis technique. Besides two researchers independently conducted the thematic analysis. <h3>Results</h3> Totally nine main themes were determined. Key themes comprising the behavioural capability were <sup>1</sup>lack of knowledge on PA and <sup>2</sup>person-centered approach. Outcome expectations are associated with <sup>1</sup>health benefits. It emerged that self-efficiency is affected by four themes as follows; <sup>1</sup>past negative experiences, <sup>2</sup>environmental barriers, <sup>3</sup>personal barriers and <sup>4</sup>follow up. Besides, <sup>1</sup>incorporating the PA into daily life were categorized as self-regulation and <sup>1</sup>constructive social dialogs categorized as social support parameters of the theory. The themes, subthemes and supporting quotations related to the SCT structures are summarized in Table 1. <h3>Conclusion</h3> This study revealed the factors, needs, and beliefs related to PA behaviour in FM patients based on SCT and provided suggestions for how SCT constructs could be used to develop the optimal PA intervention. Future research should design PA interventions for FM patients based on behaviour change theories and evaluate the efficacy of these interventions. <h3>References</h3> [1]Mcloughlin, M. J., Colbert, L. H., Stegner, A. J., &amp; Cook, D. B. (2011). Are women with fibromyalgia less physically active than healthy women?. Medicine and science in sports and exercise, 43(5), 905. [2]O'Dwyer, T., Maguire, S., Mockler, D., Durcan, L., &amp; Wilson, F. (2019). Behaviour change interventions targeting physical activity in adults with fibromyalgia: a systematic review. Rheumatology international, 39(5), 805-817. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1455 INTERSTITIAL LUNG DISEASE IN SJOGREN’S SYNDROME: PREVALENCE, PATTERNS, TREATMENT, AND PROGNOSIS
Authors: J. H. Koh, Y. Park, J. J. Lee, H. Jeon, S. J. Moon, Y. H. Kim, J. K. Min, S. K. Kwok
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Interstitial lung disease (ILD) is a potentially serious yet underdiagnosed manifestation of primary Sjogren's syndrome (pSS). <h3>Objectives</h3> This observational study aimed to investigate the clinical, functional, and imaging characteristics of ILD in pSS, together with treatment and prognosis. <h3>Methods</h3> Longitudinal clinical and laboratory data of patients with pSS were extracted from three hospitals of the Catholic Medical Center through a clinical data warehouse, between March 1, 2012, and February 28, 2022. Predisposing factors for the development of ILD and acute exacerbation were identified using a logistic regression model. <h3>Results</h3> A total of 1,402 patients with pSS were included in this study (Female, 98%; median age, 55 years). Among them, 92 patients with pSS (7%) were comorbid with ILD (21 biopsy-proven cases). Fibrosing nonspecific interstitial pneumonia (NSIP) was the most prevalent CT pattern in pSS-ILD (58%), followed by usual interstitial pneumonia (20%), and organizing pneumonia (16%). At the diagnosis with pSS-ILD, 64% of patients showed reduced diffusion capacity, and 54.3% of patients with pSS-ILD showed a restrictive functional pattern. The median follow-up period was 3.2 years. During follow-up, six patients died (6.5%) and 26 patients (28.3%) experienced acute exacerbation (AE). However, 64% of patients showed no AE without treatment. Lower baseline forced vital capacity (FVC) (Odds ratio (OR), 0.962, P = 0.026) and high neutrophil-to-lymphocyte ratio (OR, 3.59, P = 0.046) were significant predisposing factors for AE. <h3>Conclusion</h3> ILD accounted for 7% of the comorbidity of SS, and 64% showed stable lung function without treatment. AE was associated with NLR and baseline FVC. <h3>References</h3> [1]Flament T, Bigot A, Chaigne B, Henique H, Diot E, Marchand-Adam S: <b>Pulmonary manifestations of Sjögren's syndrome</b>. <i>Eur Respir Rev</i> 2016, <b>25</b>(140):110-123. [2]Mikolasch TA, George PM, Sahota J, Nancarrow T, Barratt SL, Woodhead FA <i>et al</i>. <b>Multi-center evaluation of baseline neutrophil-to-lymphocyte (NLR) ratio as an independent predictor of mortality and clinical risk stratifier in idiopathic pulmonary fibrosis.</b> EClinicalMedicine. 2022 Dec 1;55:101758. [3]Kim YJ, Choe J, Kim HJ, Song JW. <b>Long-term clinical course and outcome in patients with primary Sjogren syndrome-associated interstitial lung disease</b>. Sci Rep. 2021;11(1):12827. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1394-HPR THE IMPACT OF FIBROMYALGIA ON THE SLEEP AND QUALITY OF LIFE IN WOMEN WITH FMR1 GENE PREMUTATION WITH AND WITHOUT FIBROMYALGIA
Authors: M. Pinheiro, M. Antunes, I. M. B. De Souza, A. Torres Cruz, P. De Oliveira Januário, A. Pasqual Marques
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Fibromyalgia is present in women with <i>FMR1</i> gene premutation. (Fragile X Messenger Ribonucleoprotein 1). Few studies have evaluated the impact of fibromyalgia on the sleep and on the quality of life in premutation women. <h3>Objectives</h3> The aim of the present study was to compare the impact of fibromyalgia on sleep and quality of life in women with <i>FMR1</i> gene premutation as compared to a group of paired control without fibromyalgia. <h3>Methods</h3> The study included 140 women who were divided into two groups: Women with <i>FMR1</i> Gene premutation (n=70) and Women without <i>FMR1</i> Gene premutation (n=70). The impact of fibromyalgia on quality of life was verified using the Fibromyalgia Impact Questionnaire - QIF, validated for the Brazilian version, in which the maximum score is 100 and the higher the score, the greater the impact of fibromyalgia on the quality of life. Sleep quality was assessed by the Pittsburg Sleep Quality Index, in which the sum of the scores of its components generates a global score, which varies from 0 to 21, classifying sleep quality as good, bad or presence of sleep disturbance. Data were analyzed using descriptive statistics. <h3>Results</h3> Among premutated women group, the mean age was 41.96 ± 8.02 years, most of them white (81.43%) and with a (post-) graduate degree (48.57%). Among women without premutation, the mean age was 38.51 ± 10.24 years and the majority was white (58.57%) and had a (post-) graduate degree (64.28%). In the women premutation group the impact of fibromyalgia on quality of life was 39.68±19.27 points, indicating a medium impact on quality of life. As to sleep quality, 17.14% presented good quality, 51.43% poor and 31.43% disturbed. In the contol group, the impact of fibromyalgia on quality of life was 30.97 ± 18.76 points, indicating medium impact and on sleep, 14.00% presented good quality, 51.43% poor and 20.00% sleep disturbance. <h3>Conclusion</h3> The present study confirms that the impact on quality of life and sleep disturbance seems to be greater in women with <i>FMR1</i> gene premutation when compared to control women without the premutation. <h3>References</h3> [1]Hagerman RJ, Protic D, Rajaratnam A, Salcedo-Arellano MJ, Aydin E Y, Schneider A. Fragile X-associated neuropsychiatric disorders (FXAND). Frontiers in Psychiatry. 2018; 9: 564. [2]Johnson K, Herring J, Richstein J. Fragile X premutation associated conditions (FXPAC). Frontiers in Pediatrics, 2020; 8: 266. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1482 PREDICTORS AND CLINICAL SIGNIFICANCE OF LUPUS LOW DISEASE ACTIVITY STATE 12 MONTHS AFTER LUPUS NEPHRITIS
Authors: C. K. Cheung, S. C. W. Chan, C. S. Lau
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Lupus nephritis (LN) is a significant comorbidity that affects around 50% of patients with systemic lupus erythematosus (SLE). Complete or partial renal response 12 months after LN is a recommended treatment target. Low disease activity in extra-renal domains by achieving LLDAS may also contribute to one of the critical treatment goals in LN patients <sup>[1]</sup>. However, the predictors of LLDAS in LN patients and the renal-specific benefits of LLDAS were also not fully understood. <h3>Objectives</h3> To investigate the predictors of LLDAS at 12 months post-LN and the clinical usefulness of achieving this state in LN patients. <h3>Methods</h3> Patients with biopsy-proven LN during 2010-2020 were included. Baseline demographics, blood parameters and urinalysis results were recorded. Patients were then followed up every 4 months to repeat blood tests and urinalysis. Renal response and LLDAS were assessed at 12 months post-LN, and any future relapses were recorded. Complete renal response (CRR) was defined as proteinuria ≤0.5g/day with normal estimate glomerular filtration rate (eGFR); partial renal response (PRR) was defined as a reduction in proteinuria by ≥50% with near normal eGFR. LLDAS was attained by meeting: (1) SLE Disease Activity Index ≤4 with no major organ activity; (2) no new lupus disease; (3) physician global assessment ≤1; (4) prednisolone dose ≤7.5mg; (5) standard maintenance immunosuppressants <sup>[1]</sup>. Relapse was a biopsy-proven LN after an initial treatment response of proteinuria reduction of ≥50% or to subnephrotic range. We assessed the predictors of LLDAS at 12 months post-LN and performed time-to-relapse survival analysis. <h3>Results</h3> 143 LN patients were included with a median follow-up duration of 10.4 years. At 12 months, 57 (40%), 14 (10%) and 69 (48%) patients achieved CRR, PRR and LLDAS, respectively. Among 136 patients who achieved treatment response, 30 (22%) patients developed LN relapse after a median of 2.98 years. LN at age greater than 30 or the presence anti-smith autoantibodies had significantly lower odds of reaching LLDAS at 12 months after LN, with odds ratio of 0.35 (<i>p</i> = 0.047) and 0.30 (<i>p</i> = 0.043) respectively (Table 1). Patients reaching CRR/PRR and LLDAS both had a significantly lower chance of relapse with <i>p</i> = 0.014 and <i>p</i> = 0.002 respectively (Figure 1). <h3>Conclusion</h3> Age of LN and anti-smith autoantibodies are predictors of LLDAS 12 months post-LN. We advocate LLDAS as a target for LN patients as LLDAS attainment lowers the risk of future relapse. <h3>Reference</h3> [1]Franklyn K, Lau CS, Navarra SV, et al. Definition and initial validation of a Lupus Low Disease Activity State (LLDAS). Ann Rheum Dis 2016;75(9):1615-21. doi: 10.1136/annrheumdis-2015-207726 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1390-HPR LUPUS NEPHRITIS PROFILE IN TUNISIAN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS
Authors: M. Cherichi, Y. Boussoukaya, M. Elghali, N. Sakly, M. Jguirim, S. Hammami
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Lupus Nephritis(LN) is associated with morbidity and worse survival and its clinical, the immunological and the follow-up profile varies between studies due to race and ethnicities differences. Previous studies have evaluated clinical and immunological factors associated with LN. only few studies were done in the north African region. <h3>Objectives</h3> To define clinical, immunological and treatment differences according to the presence of lupus nephritis (LN) in tunisian Systemic Lupus Erythematosus (SLE) patients. <h3>Methods</h3> We studied SLE 141 patients. A clinical examination and a laboratory evaluation were performed in all SLE patients at the onset of the disease. <h3>Results</h3> Of all patients, 26.24% presented LN. The mean age of patients with LN was lower than patients without LN (34.3 ±14.61 years vs 40.46 ±14.94 years). LN was associated with pleural effusion, pericarditis, higher SLEDAI score, higher levels of creatinine and proteinuria, lower rate of glomerular filtration, anemia, leukopenia, thrombocytopenia, necessity of immunosuppressive drugs, antibodies such as anti-dsDNA, anti-Sm, anti-Sm/RNP and anti-SSA/La. In terms of renal histopathological findings, when we combined class IV and V (profilerative nephritis), we found that this form was more prevalent (56.8%) and associated with higher rate of proteinuria, C-reactive protein and necessity of immunosuprissive drugs. <h3>Conclusion</h3> The north African studies in the term of Lupus Nephritis are scarce. Nonetheless, severe forms seem to be frequent with a high prevalence of proliferative nephritis in our study. Pleural effusion, anti-dsDNA positivity, leukopenia and thrombocytopenia are the predective factors to develop LN. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1354 REGRESSION TO THE MEAN FOR PAIN OUTCOMES IN CLINICAL TRIALS FOR KNEE OSTEOARTHRITIS
Authors: M. Englund, A. Turkiewicz
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Improvements in pain in clinical trials for osteoarthritis (OA) are largely contextual.(1) Given known fluctuations of osteoarthritic pain, a substantial proportion of contextual response could be explained by the regression-to-the-mean (RTM) phenomenon. <h3>Objectives</h3> To estimate the size of RTM for a typical OA trial with pain as outcome. <h3>Methods</h3> We included participants of Osteoarthritis Initiative who fulfilled inclusion criteria typically required for enrolment in a clinical trial. These included: age 40-79 years, symptomatic knee OA, Kellgren-Lawrence grade 2-3, use of pain medication more than half the days of a month in past 12 months, numerical rating scale (NRS) pain of 4 to 9 in the target knee. We studied observed changes in the mean levels of pain with respect to conditioning on current knee pain. <h3>Results</h3> We identified 459 subjects who fulfilled inclusion criteria on at least one annual follow-up between year 1 and year 8. In these subjects, the mean NRS pain level at each follow-up time point was similar, ~4.6, but at the time of fulfilling the inclusion criteria, the mean level of pain in the same subjects was 6.2 (Figure 1). The difference in NRS pain between the theoretical point of inclusion in a trial and one year after was -0.8 (95% confidence interval -0.6, -0.9). <h3>Conclusion</h3> RTM in a typical osteoarthritis trial is likely to explain as much as about 0.8 NRS point improvement on a 0 to 10-point scale. RTM is a powerful phenomenon that may mislead interpretation of effectiveness as it neither represents improvement from the intervention nor placebo response. <h3>Reference</h3> [1]Zou K, Wong J, Abdullah N, Chen X, Smith T, Doherty M, Zhang W. Examination of overall treatment effect and the proportion attributable to contextual effect in osteoarthritis: meta-analysis of randomised controlled trials. Ann Rheum Dis. 2016 Nov;75(11):1964-1970. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Martin Englund Consultant of: Cellcolabs AB (Sweden) and Key2Compliance AB (Sweden), Aleksandra Turkiewicz: None declared.
POS1374 RELATIONSHIP BETWEEN POSSIBLE TIBIOFEMORAL OSTEOPHYTE AND CREPITUS AND EFFUSION IN PATIENTS WITH KNEE SYMPTOMS BUT WITHOUT JOINT SPACE NARROWING
Authors: A. Mahmoudian, M. Englund
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Osteophytes are common structural sign identified to be associated with knee osteoarthritis (OA) and has been included as a criterion for presence and progression of knee OA. <h3>Objectives</h3> Our aim was to investigate the association of possible tibiofemoral osteophyte with knee-joint-related physical examination in symptomatic knees without radiographically detected joint space narrowing. <h3>Methods</h3> We used the Osteoarthritis Initiative (OAI) open access database (http://www.oai.ucs.edu), approved by the local institutional review boards. The OAI comprises data of 4796 men and women aged 45–79 years at baseline. We selected subjects, from the following two sub-cohorts: 1) progression cohort, individuals with symptomatic knee OA (n=1390); 2) incidence cohort, individuals at risk for knee OA (n=3284). Crepitus was examined at baseline by placing the palm of the hand over the patella to detect the presence of a continuous grinding sensation during passive knee flexion-extension movement in the supine position. A positive bulge sign was considered as presence of knee joint effusion. We included subjects with no joint space narrowing but no or doubtful osteophyte in either knee at baseline based on fixed-flexion posteroanterior knee radiographs. We further required subjects to have answered YES to the following question at baseline: "<i>Do you have knee pain, aching or stiffness for more than half the days of a month during the past 12 months?</i>" We used unconditional logistic regression to evaluate the association between the presence of knee crepitus and effusion possible tibiofemoral osteophyte. Only one knee per subject was randomly included if both knees were eligible. In the first model the outcome was structural OA development irrespective of knee symptoms at 4 years, and in the second model we required the presence of knee pain, aching or stiffness also at the 4-year follow-up (i.e., the subjects remained symptomatic). <h3>Results</h3> We included 726 subjects with no or little radiographic evidence of OA and a symptomatic knee (60% women, mean [SD] age 58.9 [8.5], BMI 29.6 [4.9]. Our results indicated that presence of crepitus and/or effusion on physical examination were (statistically) significantly associated with possible tibiofemoral osteophyte (<b>Table 1</b>). <h3>Conclusion</h3> Presence of both crepitus and effusion at examination in subjects with no or minimal radiographic OA of their symptomatic knee showed moderate association with possible osteophyte in the tibiofemoral joint. An important limitation is that radiographic changes in the patellofemoral joint was not systematically evaluated within the OAI. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0171 MENDELIAN RANDOMIZATION ANALYSIS REVEALS CAUSAL EFFECTS OF GUT MICROBIOTA ABUNDANCE ON GIANT CELL ARTERITIS RISK
Authors: Z. Han, J. Hu, Z. Zhang, Q. Yu, P. F. He, X. Li, S. X. Zhang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Gut microbiota (GM) abundance is associated with giant cell arteritis, but their causality remains unclear<sup>[1]</sup>. <h3>Objectives</h3> In order to comprehensively investigate the causal relationship between gut microbiota abundance and giant cell arteritis risk and to identify specific beneficial or pathogenic microbe taxa, we performed a two-sample Mendelian randomized (MR) analysis. <h3>Methods</h3> MR analysis was conducted on genome-wide association study (GWAS) summary statistics of gut microbiota abundance and giant cell arteritis. Specifically, the microbiome GWAS in 14,306 individuals from the MiBioGen consortium was used as exposure<sup>[2]</sup>, while the GWAS (n = 213,604) for giant cell arteritis was used as the outcome. At the suggestive significance level (p = 1×10<sup>-5</sup>), SNPs associated with bacteria abundance were utilized as instrumental variables. Inverse variance weighted (IVW) was the primary method for analyzing causality, and Cochran's Q statistic was used to quantify the heterogeneity of instrumental variables. <h3>Results</h3> Inverse variance weighted estimates suggested that genus Eubacterium rectale group (odds ratio = 0.38, 95% confidence interval: 0.16-0.93, P = 0.03), class bacteroidia (odds ratio = 0.44, 95% confidence interval: 0.21-0.93, P = 0.03), order Bacteroidales (odds ratio = 0.44, 95% confidence interval: 0.21-0.93, P = 0.03), family Lachnospiraceae (odds ratio = 0.32, 95% confidence interval: 0.16-0.63, P = 0.001) and genus Lactobacillus (odds ratio = 0.6, 95% confidence interval: 0.37-0.97, P = 0.04) had a protective effect on Giant cell arteritis. In addition, the relative abundance of class Betaproteobacteria (odds ratio = 2.53, 95% confidence interval: 1.03-6.19, P = 0.04) and relative abundance of genus Ruminococcaceae (odds ratio = 1.7, 95% confidence interval: 1.04-2.8, P = 0.04) were negative significant correlated with Giant cell arteritis risk (Figure 1). Further sensitivity analyses validated the robustness of the MR results. <h3>Conclusion</h3> The study suggested that gut microbiota abundance was causally associated with the risk of giant cell arteritis, which may provide novel insights into the prevention and diagnosis of giant cell arteritis. <h3>References</h3> [1]Tariq, S. &amp; Clifford, A. H. An update on the microbiome in vasculitis. <i>Current opinion in rheumatology</i><b>33</b>, 15-23, doi:10.1097/bor.0000000000000758 (2021). [2]Kurilshikov, A. &amp; Medina-Gomez, C. Large-scale association analyses identify host factors influencing human gut microbiome composition. <b>53</b>, 156-165, doi:10.1038/s41588-020-00763-1 (2021). <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1389-HPR AGE-SUBSET INCIDENCE AND PREVALENCE ANALYSIS OF JUVENILE SYSTEMIC SCLEROSIS IN THE UNITED STATES
Authors: J. Mattson, H. Bao, M. Flack, K. Coeytaux
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Juvenile systemic sclerosis (jSSc) is an extremely rare orphan disease. To date, there is very limited published data regarding incidence and prevalence of jSSc. Specifically, there are no published data on jSSc incidence rates by age group and only one Columbian report of jSSc prevalence rates by age group. These data are important given the significant developmental differences between age subsets. <h3>Objectives</h3> To evaluate jSSc age-subset incidence and prevalence using U.S. administrative claims data. <h3>Methods</h3> Children &lt;18 years old with medical claims for SSc and who received methotrexate, mycophenolate mofetil, or cyclophosphamide at a pediatric age (&lt;18 years old) were identified from the OPTUM Clinformatics claims database 2007-2021. jSSc patients were identified using ≥2 medical claims (710.1, 517.2 for ICD-9-CM codes and M34, M34.x for ICD-10-CM codes) for SSc on different dates within a 1-year period. Incidence and prevalence were estimated overall, by age group, and were age and sex adjusted using 2020 US census data. <h3>Results</h3> Adjusted incidence and prevalence estimates are presented in the table below. Overall, jSSc incidence and prevalence rates among children in the US were 1.4 per million person-years (PY) and 7.3 per million, respectively. Both incidence and prevalence rates increased with age. <h3>Conclusion</h3> jSSc is an extremely rare disease with incidence and prevalence rates increasing with age. Specifically, incidence and prevalence rates vary dramatically for different age subsets, with increasing rates at 10 years and older. To our knowledge, this is the first study to estimate jSSc incidence and prevalence rates by age group. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> John Mattson Employee of: Boehringer Ingelheim Pharmaceuticals Inc, Haikun Bao Employee of: Boehringer Ingelheim Pharmaceuticals Inc, Mary Flack Employee of: Boehringer Ingelheim Pharmaceuticals Inc, Karen Coeytaux Employee of: Boehringer Ingelheim Pharmaceuticals Inc.